Metabolic Effects of Alcohol on the Liver

Abstract

On the basis of the numerous reports cited and reviewed here it is quite evident that alcohol has many effects on the metabolism and function of the liver. Some of these effects have been observed in chronic experiments; others were observed in more acute studies in animals and man. A number of the effects appear to be direct and hence might be termed "toxic." However, many of the actions of alcohol are more indirect. Thus, for example, alcohol has actions upon organs such as the pituitary and adrenal glands, derangements in hepatic metabolism being secondary to altered hormonal secretions. On the other hand, a number of the indirect effects of alcohol are due to its oxidation and the accumulation of products such as reduced diphosphopyridine nucleotide (DPNH). It was indicated that some of the changes in the metabolism of lipids, carbohydrates and purines (such as uric acid) are a direct consequence of increased DPNH levels in the liver cell. Knowledge concerning the metabolic actions of alcohol has provided a clearer insight into the mechanism leading to the development of such clinical disorders as the hypoglycemia and fatty liver of the alcoholic patient. The question naturally arises of the extent to which these metabolic actions may be implicated in the development of the most frequently seen chronic disease of the alcoholic patient[long dash]namely, Laennec''s cirrhosis. Although no firm conclusions can yet be arrived at, it seems inescapable that in addition to the significance of impaired nutrition, the direct and indirect metabolic actions of alcohol on the liver must have some role in the pathogenesis of Laennec''s cirrhosis.